News Capsules (Summer 1997)

In case you have not heard, the managed care industry has instituted another divisive measure that is bound to cause resentment within the ranks of medicine: Oxford Health Plans, Inc. and Columbia Presbyterian Medical Center have struck a deal to assign primary care status to nurse practitioners who will be paid at the same rate as physicians.

Kenneth Shine, president of the Institute of Medicine, reportedly a nonpartisan agency which according to The Wall Street Journal (02/07/97) advises Congress on medical matters, opined: “It could be a very important landmark demonstration for other parts of the country.”

Prudential Insurance Company of America’s Prudential HealthCare is also said to be at the point of reaching a similar agreement with the same group of nurses at Columbia. According to the same report: “Rates the managed-care companies pay for primary-care services will be the same, no matter whether a member is cared for by a nurse-practitioner or a doctor from Columbia. Officials say that financial parity with doctors is crucial. If the idea had to be promoted as a cheaper alternative to a primary-care doctor, patients and employers wouldn’t buy it, experts believe.”

Government To Pay New York Hospitals to Train Fewer Doctors

In an unorthodox and unparalleled move that only government bureaucracies and committees can fathom, the New York Times reported the federal government will pay New York hospitals $400 million to train fewer doctors over the next 6 years, and thus “hope to stem the growing number of doctors” in parts of the country who, according to health care policy pundits, “drive up medical costs,” thereby saving money.

“I’ve never heard anything like this before,” said Dr. Alan Hillman, a professor of health policy at the University of Pennsylvania, “but I really can’t find any fault with it. Maybe this is one of the first rational collaborations between hospitals and government.”

Sex Ed Working?

Despite the authorities repeated calls for condom distribution and “safe sex” (but not abstinence), for the first time last year, sexually transmitted Chlamydia was the most common infectious disease in 1995 (477,638 cases). According to government figures, other STDs such as gonorrhea (392,848) and AIDS (71,547) came in second and third. Those three, together with syphilis and Hepatitis B, accounted for 87% of the total number of cases of infectious diseases caused by the top 10 maladies. (See Accuracy In Media’s “STDs — The Hidden Epidemic”.)

Of Wine and Hearts

Science continues to gather evidence that moderate use of wine, (or even beer and liquor) can be beneficial in lowering the risk of cardiac deaths.

Dr. R. Curtis Ellison, a Boston University epidemiologist, was quoted in AMNews (09/02/96) as saying that “there is an average 30% reduction in the risk of heart disease if you consume small amounts of alcohol.”

At present, one or two drinks a day (one drink = 1 beer, 4 oz. of wine, or 1-1 1/2 oz. of liquor) appear to be most beneficial.

Alcohol has been shown to increase the proportion of HDL cholesterol, the “good” cholesterol which protects the coronary arteries, and decreases LDL cholesterol, the fat linked to increased heart disease risk.

Managed Care's Shield Pierced

Until fairly recently, the managed care industry and HMOs have used the 1974 Employee Retirement Income Security Act or ERISA as a protection against lawsuits stemming from medical practice.

HMOs used the ERISA shield to protect themselves against lawsuits by claiming that they don’t administer medical treatment — all they do is pay for it.

Fortune magazine (02/03/97), citing the case Duke v. U.S. Healthcare, reports that as the ERISA shield is penetrated, “we can expect HMOs to become fair game for malpractice attorneys.”In the Duke case (1995), U.S. Healthcare refused to pay for a blood test prescribed by a physician. As a result of his failure to get the test promptly, the man died and his widow sued. The court found the HMO liable for punitive damages.

In 1994, a Southern California jury awarded a man $3 million in damages (later reduced by state law) to compensate him for the death of his wife who died of colon cancer at the age of 35 as a result of delayed referral to a specialist by an HMO “withholding care to save money.”

Vox Populi

Regarding an article exempting HMOs from litigation, a reader wrote: “To deny a patient treatment, calling it a ‘benefit decision’ and shifting responsibility for the resulting physician injury (and sometimes death) to the patient’s employer or doctor who was probably overruled by the HMO, is a practice that needs to be outlawed.

“The only persons ‘benefiting’ from denying treatment to patients are health insurance CEOs, making multimillion dollar salaries and HMO shareholders. Some of these HMO CEOs make the Robber Barons of history look like Boy Scouts.

Dr. Nino Camardese, through his Freedom in Medicine Foundation, has sent an open letter to his patients urging them to join him and reclaim American medicine and support MSAs as the medical reincarnation of the Declaration of Independence.

In 1994, Dr. Camardese was bestowed thehonor of having the Nino M. Camardese Medical Library at the Fisher Titus Medical Center in Norwalk, Ohio named after him by his colleagues and the Board of Trustees.

Books in Brief

I have highlighted and listed three books pertaining to AIDS — books that contain great ideas, solid data, and sound reasoning, and yet, although all three, in my opinion, are written from the right side of the political track, each focuses on different aspects of AIDS and arrives at different conclusions regarding this epidemic.

In the Summer 1997 issue of the Medical Sentinel, we have featured an article by Stanley K. Monteith, M.D. (pp. 97-100) with replies by Michael Fumento and Dr. Peter Duesberg — the provocative authors of the two other “books in brief.” Feel free to use this section as a sounding board for the formulation of your own introspective views on this dreadful and frightening malady.

“For 5 years, Dr. Monteith battled within the structure of organized medicine in an effort to have HIV considered an infectious disease...The book takes the reader behind the political machinations within organized medicine and the U.S. Public Health Service.” The author, an orthopedic surgeon who has practiced in California for over 30 years, warns that unless sound public health measures are instituted “we may soon see the same breakdown in the structure of our society that is, today, occurring across the continent of Africa.”

The Myth of Heterosexual AIDS: How a Tragedy has been Distorted by the Media and Partisan Politics by Michael Fumento, New York, NY, Basic Books, Inc. Publishers, 1990, 411 pp., ISBN: 0-465-090803-7, $22.95 (Hard cover).

By using solid research and citing accurate information published in this book, Michael Fumento debunked the liberals and the popular media hysterical assertions that “one in five heterosexuals could be dead from AIDS in the next three years.” He also predicted that AIDS would soon peak (which it did) and plateau, as the scenario that AIDS would spread to the heterosexual population was unlikely for reasons he cogently expounded upon in this book.

In this controversial book, Dr. Duesberg calls for alternative hypotheses that truly use the scientific method to compete with the prevailing theory that H.I.V. causes AIDS. He then formulates the scientifically testable but unorthodox hypothesis that long term consumption of recreational drugs and antiviral drugs like AZT are responsible for AIDS. In a letter to the New York Times, Dr. Duesberg writes: “12 years and $35 billion after starting the war on AIDS in the name of the hypothesis that H.I.V. causes AIDS, America has no vaccine and no drug, has lost over 300,000 lives to AIDS and has yet to save the first AIDS patient.”—Editor